| NPI | 1417424060 |
|---|---|
| Former Name | LAURA WOOTTEN RUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MS D1714) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2018-10-31 |